When a top health care expert, Harvey V. Fineberg, was named president of the Gordon and Betty Moore Foundation last year, we were told by the foundation that the appointment didn't portend any future expansion of health care funding.
Yeah, right, we thought: Giving Pledge signatories Gordon and Betty Moore are sitting on a $6.9 billion fortune (quite apart from their foundation's comparable endowment), the couple has a keen interest in health care, and now they'd recruited a leading thinker in this area. A bigger Moore health care play at some point seemed inevitable to us. As we wrote at the time, "It's hard to imagine that the foundation won't go deeper into this area with Fineberg at the helm." Among other things, Fineberg has expertise on some of the most pressing challenges facing the health care sytem, particularly how to control costs and improve patient outcomes.
We're still waiting for our prediction to come true and a big new Moore health care initiative to come rolling out. In the meantime, one thing Fineberg has been doing as the foundation's new president is also serving as the interim chief program officers of Patient Care, the division at Moore that manages its health care funding.
An interesting goal of that work is get to patients and families more engaged in their health care. Such enfranchisement is a powerful thing, and Moore has been funding research to figure out just how powerful.
For example, it’s been well documented that patients who are able to control their own pain meds use less of them, but apparently, the positive effects go even beyond that, to metrics that track costs and even cures. That's among the findings of a new Moore-backed study by researchers from George Washington University, the University of Oregon, and Fairview Medical Group.
Thirty-two thousand primary care patients, most of them female, were studied over the course of two years. The study, titled "When Patient Activation Levels Change, Health Outcomes and Costs Change, Too," found that a higher “activation level”—in other words, greater patient involvement in managing their own care—led to better outcomes for nine out of thirteen indicators. That even includes clinical indicators associated with disorders like diabetes and heart disease.
That’s nothing to sneeze at. It's a big saving, which could help usher in a whole different approach to patient treatment—one in which the patient-doctor line gets blurred in favor of a more hands-on approach for patients.
The study also found—maybe not surprisingly—that patients who were engaged in their own care were more likely to display healthy behaviors. That includes everything from scheduling pap smears to flossing.
Where the wheels really hit the road is in tracking costs. Among the patients who exhibited the highest of four activation levels during the course of the study, project billed costs were a whopping 31 percent lower. While the report doesn’t necessarily “prove causality” between patient engagement and better clinical outcomes, the association is still a positive one. The study was published in Health Affairs.
"For accountable care organizations and other delivery systems looking to reduce costs and improve the health of those they care for, this study suggests that patient activation can be a critical pathway to achieving these goals," said Judith Hibbard, professor emerita and senior researcher of the Health Policy Research Group at the University of Oregon. "The greater the activation level, the greater the odds of better outcomes and lower costs."
Now all we need is a big foundation to launch a major new initiative to help foster such greater activitation.